Primary liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer death worldwide in 2020. [1] .Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer in adults and is currently the most common cause of death in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.
Serological markers for hepatocellular carcinoma (HCC) are important for early diagnosis, as well as monitoring of tumour aggressiveness, treatment responsiveness, recurrence and survival. [1]
HCC is commonly performed using serum marker alfa-fetoprotein (AFP) often in combination with ultrasonography. [2] Ferritin is another commonly used clinical cancer biomarker, as cancer may alter the whole body iron metabolism, occasionally reflected in the change of the serum ferritin levels.[3,4]
Clinical Significance
AFP is a serum glycoprotein that was first recognized as a marker for HCC more than 40 years ago and has since been described to detect preclinical HCC.[3] As a significant markers for HCC, AFP is helpful in assessing problems in management of HCC and monitoring treatment regiments. In addition, AFP is also an indicator of HCC risks mostly in patients with cirrhosis and HCV/HBV infections.[6]
Recent studies have found that tumor tissue can synthesize and secrete ferritin. It is reported that Ferritin has a sensitivity of 50.8% to 88.0% for the diagnosis of liver cancer. Also, NACB suggest that Ferritin can be used to monitor HCC in patients whose tumors do not produce AFP [7].